Most Relevant Information
Provider Data
| NPI Number: | 1003456286 |
| Provider Name: | KELLEY MAMEDE PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/15/2020 |
| Last Updated: | 08/18/2022 |
Provider Practice Location
402 S STATE ST
MARION
OH
433025000
Practice Location Phone/Fax
| Phone: | 7403870650 |
| Fax: |
Provider Mailing Location
70 BUR REED RD
DELAWARE
OH
430153676
Provider Mailing Phone/Fax
| Phone: | 3306209432 |
| Fax: |